Objective: To study the current situation of sleep quality of senior high school students and analyze the influencing factors, so as to provide a reference for targeted sleep quality improvement of high school students. Methods: A total of 4 793 senior high school students of different grades were recruited from four different regions (Shanghai, Qinghai, Macao, Henan) in 2020. The information of demographic, sleep status, mental factors, living habits and other information were collected by questionnaire. Descriptive statistics and Logistic regression were used to analyze sleep quality and its influencing factors of the senior high school students. Results: About 24.2% of senior high school students reported sleep problems and 71.4% slept less than 7 hours at night. Interpersonal sensitivity, depression, anxiety symptoms, learning, family and interpersonal stress had significant effects on sleep problems in senior high school students( χ 2=1 147.98, 1 228.35, 1 032.54, 371.05, 497.61, 475.39, P <0.01). Drinking coffee and tea, drinking alcohol, smoking (including secondhand smoke), long term use of electronic products, late sleep, bedtime diet, poor sleep environment, parents with sleep problems were the risk factors for sleep disorders of senior high school students, regular exercise was the protective factors for sleep disorders of senior high school students, the influence was significant ( χ 2=160.28, 127.73 , 108.02, 113.27, 470.91, 340.95, 72.02, 155.53, 116.30, 76.96, 28.75, 12.89, P <0.05). Conclusion The sleep quality of senior high school students needs to be improved. Schools and parents should pay attention to the mental health and living habits of senior high school students to help them improve their sleep quality and grow up smoothly.

Objective:To evaluate the application effect of the nurse-led catheter extraction assessment model for children in PICU.Methods:From January to May 2020, 100 children with short-term catheter in PICU of Guangzhou Women and Children Medical Center were selected by convenient sampling method as the experimental group, the need for urethral catheter indwelling was assessed daily using an evidence-based assessment scale in PICU children, and the unnecessary indwelling catheters were removed timely, and 109 children with indwelling urethral catheters from August to December 2019 were collected as the control group, the catheter was removed by the nurse on medical advice, recorded and compared days of indwelling of catheters, the incidence of patients with catheter-associated urinary tract infection , resetting of catheters and the length of stay in ICU between the two groups.Results:The median and interquartile spacing of the days with indwelling catheter were 5.0 (6.0) days in the experimental group and 6.0 (6.0) days in the control group ( Z=-2.01, P<0.05) . In the experimental group, the incidence of catheter-associated urinary tract infection was 1.000 percent (1/100), and in the control group, the incidence of catheter-associated urinary tract infection was 1.835 percent (2/109); in the experimental group, 2 cases of urethral catheter were reset, and in the control group, 2 cases of urethral catheter were reset; the median and interquartile spacing of the length of stay in ICU was 6.5 (7.0) days in the experimental group and 7.0 (8.0) days in the control group. The differences of the above three indexes between the two groups were statistically significant ( χ2=0.26, 0.01, Z=-0.96, all P>0.05). Conclusions:The nurse-led catheter extraction assessment model for children can effectively shorten the catheter indwelling days for children in PICU, which has certain clinical practice significance for reducing the incidence of catheter-associated urinary tract infection.

Protein self-assemblies at the micro- and nano-scale are of great interest because of their morphological diversity and good biocompatibility. High-throughput screening of protein self-assembly at different scales and morphologies using protein crystallization screening conditions is an emerging method. When using this method to screen protein self-assembly conditions, some apparently transparent droplets are often observed, in which it is not clear whether self-assembly occurs. We explored the interaction between β-lactoglobulin and the protein crystallization kit Index™ C10 and observed the presence of micro- and nano-scale protein self-assemblies in the transparent droplets. The diverse morphology of the micro- and nano-scale self-assemblies in the transparent droplets formed by mixing different initial concentrations of β-lactoglobulin and Index™ C10 was further investigated by scanning electron microscope. Self-assembly process of fluorescence-labelled β-lactoglobulin was monitored continuously by laser confocal microscope, allowing real-time observation of the liquid-liquid phase separation phenomenon and the morphology of the final self-assemblies. The internal structure of the self-assemblies was gradually ordered over time by in-situ X-ray diffraction. This indicates that the self-assembly phenomenon within transparent droplets, observed in protein self-assembly condition screening experiments, is worthy of further in-depth exploration.
Crystallization ; Lactoglobulins

Objective: To compare the mutation status of epidermal growth factor receptor (EGFR) between different lesions and clini-cal characteristics of synchronous multiple ground-glass nodules (SMGGNs). Methods: A retrospective analysis was conducted using clinical data from 35 patients with SMGGNs who were admitted to and received surgery at The Fourth Hospital of Hebei Medical Uni-versity Hospital from January 2017 to December 2018. Next generation sequencing (NGS) was performed for all surgical specimens to detect the mutation status of exons 18, 19, 20, and 21 of the EGFR gene to analyze the relationship between the EGFR mutation sta-tus of the lesions and patient gender, age, lesion location, imaging manifestation of nodules, and adenocarcinoma pathological type . Results: The EGFR mutation rate was 65.7% (23/35 patients). Non-smoking patients and females had higher EGFR mutation rates (P=0.015, P<0.001). The EGFR mutation rate of invasive adenocarcinoma nodules was higher than those of atypical adenomatous hyper-plasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma ( P<0.001). Exon 19 deletion and L858R mutation were the most common mutations of the EGFR gene. There was no significant difference between the pathological subtypes of adenocarcino-ma and the EGFR mutant subtype (P=0.707). Among the 27 patients with multiple nodules with detectable EGFR mutations, the EGFR mutation rate was 85.2% (23/27 patients). Conclusions: The EGFR gene mutation status is different in patients with multiple pulmo-nary ground-glass nodules, suggesting that the occurrence and development of each nodule are independent events. EGFR gene muta-tion is closely related to the development of ground-glass nodules, especially in the invasion of tumors.

Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.

Objective To discuss the influence of psychological education on the resourcefulness of perioperative breast cancer patients. Methods Two hundred breast cancer patients from a first-class hospital in Fujian province were randomly assigned to the control group, in which routine care was done, and an intervention group, in which psychological education curriculum was employed at three stages on the basis of routine care. The resourcefulness scale was used in both two groups before and after the intervention to evaluate the score of individual and social resourcefulness and the total score of resourcefulness in these two groups. Results As to the control group, the score on individual resourcefulness and the total score on resourcefulness before and after the intervention had no significant differences (P>0.05), but the difference in the social resourcefulness scores before and after the intervention was statistically significant (P<0.05). The differences in the scores on the individual resourcefulness, social resourcefulness and the total score on resourcefulness in the intervention group before and after the intervention were all statistically different (P<0.001). What′s more, the scores of individual resourcefulness, social resourcefulness and the total score of resourcefulness between these two groups after the intervention were statistically different (P<0.001) as well. The scores of the intervention group were significantly higher than those of the control one. Conclusion The psychological education can significantly improve the resourcefulness level of perioperative breast cancer patients, which can help individuals to manage stress effectively.

Objective To explore the effects of diversified continuing nursing on recovery of patients with breast cancer after modified radical mastectomy. Methods A total of 90 patients with breast cancer after modified radical mastectomy were divided into observation group ( 45 cases ) and control group ( 45 cases ) according to random number table method. Patients in two groups received health guidance before leaving hospital, while those in observation group also received continuing nursing after leaving hospital. One month after leaving hospital, recovery of flaps and function of affected upper limb were evaluated. Results The flaps recovery of patients in observation group were better than those in control group with a significant difference ( P<0. 05). There were statistically significant differences in horizontal abduction of shoulder joint, upward abduction of shoulder joint, dorsiflexion of middle finger, distance of seventh cervical vertebra between two groups ( P<0. 05). Conclusions Diversified continuing nursing can effectively reduce complications of breast cancer after modified radical mastectomy and promote function recovery of the upper limb of patients.

Objective To investigate the application of Resourcefulness Scale ( RS) and evaluate its reliability and validity. Methods By five steps of translation, back-translation, comprehension, group discussion and expert discussion, the RS was translated into Chinese and went on cultural debugging. Totals of 330 patients with breast cancer were randomly selected to evaluate the reliability and validity. Results After translation and cultural debugging, the content reliability was 0. 90. The Cronbach′sαof internal consistency of the scale was 0. 825. The retest reliability was 0. 852. The retest reliability within each item was 0. 68-0. 82. The correlation index between the whole scale and each item were 0. 40-0. 66. The correlation index of reflect learning RS and social RS was 0. 432. The Chinese RS exploratory factor extracted two factors, which could explain 80. 22% variables. Conclusions Chinese RS has a high reliability and validity, so it can serve as an evaluation tool for patients with breast cancer.